Date of Award


Degree Name

PhD Nursing

Dissertation Committee

Cynthia D. Connelly, PhD, RN, FAAN, Chair; Ruth A. Bush, PhD, MPH, Chairperson; Jane M. Georges, PhD, RN Chairperson


sex trafficking, sexual exploitation, survival, grooming, exiting


Purpose: Gain a deeper understanding of how former victims of sex trafficking survive.

Background: Trafficking in persons, or human sex trafficking, is the fastest growing criminal enterprise in the United States, leading both drugs and weapons (U.S. Department of State, 2016). The hidden and protected nature of sex trafficking makes it difficult to identify exactly how many people are involved in the industry, nonetheless estimates range from 1.5 to 2.5 million victims currently in captivity within the U.S. The majority of victims are female (80%) and 50% are minors (Polaris, 2017). Once in captivity, victims face significant physical, emotional, psychological, sexual, and spiritual trauma having profound and lasting effects (Bergquist, 2015). The status of research on sex trafficking has been characterized as methodologically inadequate and lacking a sufficient theoretical framework necessary for solution and prevention development.

Methods: Grounded theory design. 15 participants were recruited and enrolled from 2 advocacy and resource groups. Inclusion criteria: individuals over 18 who self-identify as survivors of sex trafficking and are willing to complete surveys and a face-to-face interview. Semi-structured qualitative interviews were centered around the themes of personal information, current life events, expressions of Psychological Capital, early experiences of trauma or sexual abuse leading to the process of “grooming,” how life was experienced while being trafficked, the process of exiting the life, health care needs experienced, and suggestions for prevention addressed.

Results: 15 participants revealed meaningful life stories and family events, leading to grooming and entrance into victimization in sex trafficking. 4 themes of hope, self-efficacy, resilience, and optimism emerged and were discussed in relation to surviving and finally overcoming captivity. These themes present themselves in development of an emerging theory. 5 phases occur within the theory and represent the stages one progresses through as a victim, survivor, and overcomer of sex trafficking. These 5 phases are grooming, entering, surviving, exiting, and overcoming. All phases allow for unique personal experiences and time frames in the progression, or cycle, from one to the next. The theory functions for predicting, explaining, preventative, and healing (restorative) purposes.

Implications: Theoretically sound preventions and interventions are required to decrease current trends leading to exploitation and captivity into the life of sex trafficking. Findings from this study can result in information required to develop sound prevention and intervention programs for individuals, families, communities, schools, and service providers.

Document Type

Dissertation: USD Users Only